No carbohydrate diet Premise High carbohydrate diets, not fat, lead to weight gain by replacing sugar, pasta, potatoes, and bread with meat, vegetables and dairy products, you''''ll lose weight Verdict I[.]
No-carbohydrate diet Premise: High-carbohydrate diets, not fat, lead to weight gain by replacing sugar, pasta, potatoes, and bread with meat, vegetables and dairy products, you'll lose weight Verdict: Initial weight-loss is likely to be due to losing water rather than fat it's difficult to eat more meat without eating more fat, which is linked to heart disease and cancer you might be thinner, but your arteries won't be happy Hay diet Premise: It's not what you eat, it's what you eat it with carbohydrates can't be digested in acid conditions, so shouldn't be eaten with protein Mixing acid and alkaline is strictly forbidden, so fruit should never be allowed anywhere near a main meal Verdict: A mixture of foods is necessary for a healthy metabolisom-vitamin C, for instance, helps the absorption of iron Extremely fashionable but with debatable scientific basis F-plan diet Premise: This is the original high-carbohydrate, low-fat plan, advocating lots of fruit and fibre the 80s favourite has been translated into sixteen languages, and claims to be the best-selling diet ever Verdict: Common sense disguised as new scientific breakgthrough Grapefruit diet premise: More energy is spent digesting grapefruit and other foods like celery than is contained in the food itself the more you eat, logically, the thinner you get Verdict: digesting food does burn calories, but in such tiny proportions, you would have to eat a vast amount to notice any difference Cabbage soup diet Premise: By eating nothing but soup made from cabbage and a few other vegetables you can lose up to six kilos in a week Verdict: Most of the weight loss is due to water loss, not fat, and the weight returns when you move back on to solids Unfortunately side effects have been reported System S diet premise: The way to get thin is to eat sugar-coated cereals, biscuits, chocolate and sugary soft drik-"not the villains they are made out to be." It's a 'myth' that sweets make you fat and rot your teeth, so tuck into another bar of chocolate Verdict: Just ask a dentist Read the information about six diets in the article below and find out which diet F- doesn't allow you to eat fruit with your meal E- has unpleasant side effects C- allows you to eat cream B- says that sweets don't make you fat A- is based on the idea that the more you eat, the thinner you get D- has been translated into many different languages No-carbohydrate diet Grapefuit diet Hay diet F-plan diet System S diet Cabbage soup diet OLDER DADS LINKED TO RISE IN GENETIC DISORDER By Pallab Ghosh Science correspondent, BBC News A genetic study has added to evidence that the increase in some mental and other disorders may be due to men having children later in life An Icelandic company found the number of genetic mutations in children was directly related to the age of their father when they were conceived One prominent researcher suggested young men should consider freezing their sperm if they wanted to have a family in later life The research is published in Nature According to Dr Kari Stefansson, of Decode Genetics, who led the research, the results show it is the age of men, rather than women, that is likely to have an effect on the health of the child "Society has been very focused on the age of the mother But apart from [Down's Syndrome] it seems that disorders such as schizophrenia and autism are influenced by the age of the father and not the mother." Male-driven Dr Stefansson's team sequenced the DNA of 78 parents and their children This revealed a direct correlation between the number of mutations or slight alterations to the DNA, of the child and the age of their father The results indicate that a father aged 20 passes, on average, approximately 25 mutations, while a 40-year-old father passes on about 65 The study suggests that for every year a man delays fatherhood, they risk passing two more mutations on to their child What this means in terms of the impact on the health of the child is unclear But it does back studies that also show fathers are responsible for mutations and that these mutations increase with age And, for the first time, these results have been quantified and they show that 97% of all mutations passed on to children are from older fathers "No other factor is involved which for those of us working in the field is very surprising," said Dr Stefansson He added that the work backed other studies that have found links between older fathers and some disorders "The average age of fathers has been steeply rising [in industrialised countries] since 1970 Over the same period there has been an increase in autism and it is very likely that part of that rise is accounted for by the increasing age of the father," he said Genetic 'diversity' The findings should not alarm older fathers The occurrence of many of these disorders in the population is very low and so the possible doubling in risk by having a child later in life will still be a very low risk Nearly all children born to older fathers will be healthy But across the population the number of children born with disorders is likely to increase if this theory holds true Older fathers and therefore genetic mutations have been linked with neurological conditions because the brain depends on more genes for its development and regulation So mutations in genes are more likely to show up as problems in the brain than in any other organ But it is unclear whether the age of fathers has an effect on any other organ or system The research has not yet been done The reason that men rather than women drive the mutation rate is that women are born with all their eggs whereas men produce new sperm throughout their adult life It is during sperm production that genetic errors creep in, especially as men get older Writing a commentary in the Journal Nature, Prof Alexey Kondrashov, of University of Michigan, said young men might wish to consider freezing their sperm if future studies showed there were other negative effects on a child's health "Collecting the sperm of young adult men and cold storing it for later use could be a wise individual decision It might also be a valuable for public health, as such action could reduce the deterioration of the gene pool of human populations," he said Dr Stefansson, however, told BBC News that from a long-term perspective the decision by some men to have children later in life might well be speeding up the evolution of our species "The high rate of mutations is dangerous for the next generation but is generating diversity from which nature can select and further refine this product we call man," he said "So what is bad for the next generation may be good for our species in general." However a spokesman for the National Autistic Society said: "While there is evidence to suggest that genetic factors may play a role in some forms of autism, there are many 'younger' fathers who have children with the condition "Far more investigation needs to be done into the connection between genetics and autism before we can draw any reliable conclusions." All cases of genetic mutation are affected by the age of fathers in conceiving (T/F) Achizophrenia and autism are influenced by the age of A Mother B Father C Both father and mother How many people participated in the research of Dr Stefansson's team? A 20 B 78 C 97 D 25 According to the research, for one year's delay, a man passes mutation to his new born child (T/F) Most children from older father are A often sick B healthy C suffer from genetic mutation Genetic mutation is link to A health problem B social factors C neurological conditions D work It hasn't been proved the link between the genetic factors and autism (T/F) GENETIC MUTATIONS Although genetic mutations in bacteria and viruses can lead to epidemics, some epidemics are caused by bacteria and viruses that have undergone no significant genetic change In analyzing the latter, scientists have discovered the importance of social and ecological factors to epidemics Poliomyelitis, for example, emerged as an epidemic in the United States in the twentieth century; by then, modern sanitation was able to delay exposure to polio until adolescence or adulthood, at which time polio infection produced paralysis Previously, infection had occurred during infancy, when it typically provided lifelong immunity without paralysis Thus, the hygiene that helped prevent typhoid epidemics indirectly fostered a paralytic polio epidemic Another example is Lyme disease, which is caused by bacteria that are transmitted by deer ticks It occurred only sporadically during the late nineteenth century but has recently become prevalent in parts of the United States, largely due to an increase in the deer population that occurred simultaneously with the growth of the suburbs and increased outdoor recreational activities in the deer’s habitat Similarly, an outbreak of dengue hemorrhagic fever became an epidemic in Asia in the 1950’s because of ecological changes that caused Aedes aegypti, the mosquito that transmits the dengue virus, to proliferate The stage is now set in the United States for a dengue epidemic because of the inadvertent introduction and wide dissemination of another mosquito, Aedes albopictus The passage suggests that a lack of modern sanitation would make which of the following most likely to occur? a An epidemic of paralytic polio among infants b An epidemic of typhoid c An outbreak of dengue hemorrhagic fever d An epidemic of paralytic polio among adolescents and adults e An outbreak of Lyme disease According to the passage, the outbreak of dengue hemorrhagic fever in the 1950’s occurred for which of the following reasons? a The mosquito Aedes aegypti was newly introduced into Asia b More people began to visit and inhabit areas in which mosquitoes live and breed c The mosquito Aedes albopictus became infected with the dengue virus d Individuals who would normally acquire immunity to the dengue virus as infants were not infected until later in life e The mosquito Aedes aegypti became more numerous It can be inferred from the passage that Lyme disease has become prevalent in parts of the United States because of which of the following? a The inadvertent introduction of Lyme disease bacteria to the United States b The spread of Lyme disease bacteria from infected humans to noninfected humans c An increase in the number of humans who encounter deer ticks d The inability of modern sanitation methods to eradicate Lyme disease bacteria e A genetic mutation in Lyme disease bacteria that makes them more virulent Which of the following can most reasonably be concluded about the mosquito Aedes albopictus on the basis of information given in the passage? a It is native to the United States b It can proliferate only in Asia c It replaced Aedes aegypti in Asia when ecological changes altered Aedes aegypti’s habitat d It transmits the dengue virus e It caused an epidemic of dengue hemorrhagic fever in the 1950’s Which of the following best describes the organization of the passage? a A paradox is stated, discussed and left unresolved b An argument is described and is then followed by three counterexamples that refute the argument c A theory is proposed and is then followed by descriptions of three experiments that support the theory d A generalization is stated and is then followed by three instances that support the generalization e Two opposing explanations are presented, argued, and reconciled Which of the following, if true, would most strengthen the author’s assertion about the cause of the Lyme disease outbreak in the United States? a In recent years the suburbs have stopped growing b Outdoor recreation enthusiasts routinely take measures to protect themselves against Lyme disease c Scientists have not yet developed a vaccine that can prevent Lyme disease d Interest in outdoor recreation began to grow in the late nineteenth century e The deer population was smaller in the late nineteenth century than in the midtwentieth century NUTRIENTS A healthy diet is essential for maintaining a healthy body and a healthy lifestyle Though some doctors and healthy experts disagree on some components of a healthy diet, other parts are almost universally recognized, for example, all agree that a healthy diet includes necessary nutrients-ingredients that help keep bodies strong and healthy human bodies need more than 50 different kinds of nutrients, including vitamins, minerals, water, and fiber Vitamins are natural substances found in plants and animals ■ A ) A body cannot make its own vitamins, so it must get them from food Vitamins not supply energy ■ B) however, they are useful substances that the bode needs ■ C) Vitamin A, for example, helps eyes see better Vitamin B develops protein needed in muscle growth Vitamin C helps support the healing process for certain illnesses ■ D) Finally, vitamin D helps strengthen teeth and bones Minerals help balance bodily fluids, such as blood and water They are also an important part of the iron in blood There are seven major minerals that bodies need in large amounts, and ten minor, or trace, minerals, which bodies need in smaller amounts Scientist are still studying many minerals, such as nikel and cobalt, to try to understand exactly how they affect the human body Some people not include water as a nutrient, but it is vital for a healthy body to function properly Humans can live for several days without food, but only for two or three days without water People who play sports or exercise a lot often fail to drink enough water This can cause their muscles to become overly tired If not enough water is taken in during very strenuous exercise, death may in fact result Scientists have learned much about the importance of fiber in recent years ■ A) They now say that many people not get enough fiber in their diets ■ B) The average many people should eat between 30 and 40 grams of fiber each day, twice as much as the average person currently gets Though fiber is not digested or absorbed, it helps rid the body of waste products ■ C) fiber helps control weight and maintain normal levels of important substances such as cholesterol and blood sugar ■ D) Fiber is found in whole-grain breads and cereals, as well as nuts, beans, fruits, and vegetables There are several different kinds of fiber, and the each help in different ways Two kinds of fiber, called pectins and gums, are needed to help control body fats, cholesterol, and carbohydrates (a type of nutrient that produces energy) Apples, cranberries, and cherries are good sources of pectin Oatmeal and legumes are good sources of gums In general, fresh fruits and raw vegetables provide more fiber than peeled fruits and cooked vegetables according to dieticians, two servings of vegetables and two servings of whole grains ( like whole wheat bread) each day will provide enough fiber for most adults In summary, recommendations for a healthy diet include drinking lost of liquids while eating fiber from a wide variety of foods This way, the body will not be getting to much of one kind of fiber and too little of another kind If a person is not eating enough fiber now, it is best to change one’s diet gradually Above all, experts warn, not depend on getting fiber from pills or tablets A whole bottle would need to be consumed to see any benefit The word “nutrients” in paragraph is closest in meaning to a useful substance in food b regular food c source of energy for the body d substances that help the body control levels of cholestrerol The word “major” in paragraph could best be replaced by which of the following? a general b main c general d powerful The word “function” in paragraph is closest in meaning to a lie down b move c breath d operate According to the passage, which of the following is true of vitamins? a They are natural substances made by our bodies b They taste bad c Americans not get enough of them d They not supply energy to our bodies What is the main purpose of paragraph 5? a To describe the structure of fiber b To explain the history of fiber c To discuss the importance of fiber d To tell how to eat enough fiber Which of the sentences below best expresses the essential information in the highlighted sentence in the passage? Incorrect choices change the meaning in important ways or leave out essential information a (d) Though water is sometimes not classified as a nutrient, it is essential for good health b Water is not always considered nutritious; however,, it helps your body work c (b) Though nutrients are not found in water, they are essential for good health VITAMINS d (a) Water is not always considered a nutrient; however, your body needs nutrients Look at the four squares that indicate where the following sentence could be added in paragraph 2: Scientists name vitamins according to letters of the English alphabet Where would the sentence best fit? Choose the square where the sentence should be added to the passage a Paragraph 2, line b Paragraph 2, line c Paragraph 2, line d Paragraph 2, line Look at the four squares that indicate where the following sentence could be added in the paragraph 5: Too much fiber, however, can interfere with the body's ability to use essential nutrients Where would the sentence best fit? Choose the square where the sentence should be added to the passage a Paragraph 5, line b Paragraph 5, line c Paragraph 5, line d Paragraph 5, line All of the followingare good sources of fiber EXCEPT a Chocolat cake b oatmeal c apple d pears Vitamins, taken in tiny doses, are a major group of organic compounds that regulate the mechanisms by which the body converts food into energy They should not be confused with minerals, which are inorganic in their makeup Although in general the naming of vitamins followed the alphabetical order of their identification, the nomenclature of individual substances may appear to be somewhat random and disorganized Among the 13 vitamins known today, five are produced in the body Because the body produces sufficient quantities of some but not all vitamins, they must be supplemented in the daily diet Although each vitamin has its specific designation and cannot be replaced by another compound, a lack of vitamin can interfere with the processing of another When a lack of even one vitamin in a diet is continual, a vitamin deficiency may result The best way for an individual to ensure a necessary supply of vitamins is to maintain a balanced diet that includes a variety of foods and provides adequate quantities of all the compounds Some people take vitamin supplements, predominantly, in form of tablets The vitamins in such supplements are equivalent to those in food, but an adult who maintains a balanced diet does not need a daily supplement The ingestion of supplements is recommended only to correct an existing deficiency due to unbalanced diet, to provide vitamins known to be lacking in a restricted diet, or to act as a therapeutic measure in medical treatment Specifically, caution must be exercised with fat-soluble substances, such as vitamins A and D, because, taken in gigantic doses, they may present a serious health hazard over a period of time In paragraph 1, the bold word “regulate” is closest in meaning to a confine b refine c control d refresh According to the passage, vitamins are a miscellaneous substances b food particles c essential nutrients d major food groups In paragraph 1, the bold word “nomenclature” is closest in meaning to a concentration b classification c clarification d conservation How many vitamins much be derived from nourishment? a b c d 13 The author implies that foods a supplement some but not all necessary vitamins b supply some but not all necessary vitamins c are equivalent in vitamin content d should be fortified with all vitamins The bold phrase “daily diet” is closest in meaning to a nourishment intake b vitamin tablets c weight loss or gain d sufficient quantities A continual lack of one vitamin in a person’s diet is a contagious b desirable c preposterous d dangerous With which of the following statements would the author be most likely to agree? a Vitamins should come from capsules in purified form b Vitamins cannot be consistently obtained from food c An inclusive diet can provide all necessary vitamins d A varied diet needs to be supplemented with vitamins It can be inferred from the passage that vitamin supplements can be advisable a after correcting a dietary deficiency b in most restricted diets c in special medical cases d before beginning a therapeutic treatment 10 In paragraph 2, the bold phrase “act as” is closest in meaning to a attest to the fact that b fight for c pretend to be d play the role of 11 The author of the passage implies that a vitamins can be taken in very small doses b most vitamins are water-soluble c some vitamins are not fat-soluble d all vitamins are found in measured doses 12 What does the passage mainly discuss? a Vitamin categorization and medical application b Adopting vitamins to control weight c The place of vitamins in nutrition d The individual’s diet for optimum health THE SUPRISING TRUTH ABOUT SALT Even though doctors have been telling us for decades that it's one of the villains in our diet and public health leaders have started a crusade to slash salt from the food supply, there seems to be no definitive proof of stroke or heart disease prevention Here, learn why By Rachael Moeller Gorman A- Sonia Angell has a thing about salt She thinks about it much of her day When she talks on the phone from her office in Lower Manhattan, she speaks with increasing passion about the mineral — specifically, getting rid of it "It's a nutrient that we are eating in excess," she says, "to the point where it has become dangerous." B- Dr Angell is a general internist with a master's degree in public health, and she is in a good position to act on her conviction: She runs the Cardiovascular Disease Prevention and Control Program at the New York City Department of Health and Mental Hygiene (DOHMH), the same place that caused a huge uproar a few years ago when it mandated that all city restaurants get rid of artery-clogging trans fats Initially spurred on by former DOHMH Commissioner Thomas Frieden, now director of the Centers for Disease Control and Prevention, she and the Department of Health have taken on salt because they and many others in the scientific community hold that eating too much sodium chloride, or salt, causes heart attacks, strokes, and deaths So in 2008, the DOHMH spearheaded a collaboration called the National Salt Reduction Initiative — a group of more than 45 cities, states, and powerful national and international health organizations, including the American Heart Association, the American Medical Association, and the World Hypertension League — to prevent disease and death by gradually siphoning off a lot of salt from the country's food supply C- The big glitch in this impressive-sounding plan: Not everyone in the medical community agrees that limiting salt nationwide will prevent these problems "Is sodium important to most people's health? Is this a battle worth fighting for most people? The answer is no," says Norman Hollenberg, M.D., Ph.D., a kidney specialist and blood pressure researcher at Harvard Medical School who has edited books like the Atlas of Hypertension Many doctors, including journal editors, cardiologists, and medical association presidents, say that while it makes sense for some people with high blood pressure to lower their salt intake, current science doesn't show that the rest of us will reap much, if any, benefit from this sweeping policy In fact, these researchers believe the initiative is being foisted on the American public without sufficient justification — and could even be dangerous D- They say that curtailing salt in the food supply may wreak unforeseen harm, and point out that no clinical trials in the general population have linked salt to heart disease or death Past public health recommendations, they note, have backfired because they were implemented before proper studies were conducted (one example: switching from butter to trans-fat-loaded margarines — which proved to be worse) Salt is a cheap, tasty additive and preservative "There are reasons food companies put it in their products Now they have to find substitutes, and we don't know what impact the substitutes will have," says Hillel Cohen, Dr.P.H., M.P.H., an epidemiologist at the Albert Einstein College of Medicine in the Bronx who studies hypertension "Wouldn't it be nice to have some information before going ahead with a health policy that will affect millions of Americans?" The article is written by Sonia Angell (T/F) Match the two halves Glitch (N) (Para.C) Backfire (v) (para.D) Reap (v) (para.C) Foist (somebody/something on/upon somebody) (para C) Curtail (v) (Para.D) Siphon (v) (para.B) A small problem To force sb to accept sth To have opposite effect To limit sth To divert To obtain It is clear that salt can help heart disease prevention What is NOT mentioned? Eating too much salt can cause … A Diabetes B Stroke C Death What is the purpose of National Salt Reduction Initiative ? A To prevent death, diseases by controlling the amount of salt in food B To use less salt in fast food C To prevent death and diseases D To stop using salt from food supply What is "These" (these problems) ( 2nd line of para C) referred to? A Food supplies B Death and diseases C Diabetes Dr Norman Hollenberg is a blood pressure researcher at Oxford Medical School (T/F) Not all people get benefits from the policy of reducing salt from the country's food supply (T/F) 10 Gap- filling Clinical trials in the general population have linked salt to …… (2 words) or …… (1 word) SCABIES Scabies is known colloquially as the "seven year itch It is a contagious skin infection that occurs among humans and other animals It is an ancient disease Archaeological evidence from Egypt and the Middle East suggests that scabies was present as early as 4494BC It was named "scabies" by Roman physician, Celsus who is credited with describing its characteristic features Scabies is caused by a tiny and not directly visible parasite- the Sarcoptes scabiei Sarcoptes is a genus of skin parasites, which are part of a larger family of mites collectively known as "scab mites" These organisms have eight legs as adults and are placed in the same phylogenetic class (Arachnida) as spiders and ticks Pregnant female mites tunnel into the stratums corneum of a host's skin and deposit eggs in the burrows The eggs hatch into larvae in 3-10 days These young mites move about the skin an moult, into a "nymphal” stage before maturing as adults, which live 3-4 weeks within the host's skin Males roam on top of the skin, occasionally burrowing into it The movement of mites within and on the surface of the skin causes intense allergic itching The burrow tracks are often linear, to the point that a neat line of four or more closelyplaced and equally developed mosquito-like bites is almost diagnostic of the disease In the classic scenario, the itch is made more severe by warmth and is usually experienced as being worse at night, possibly because there are fewer distractions A rash soon appears after the itching starts It is typically a blotchy, lumpy red rash that can appear anywhere on the body The rash is often most obvious on the inside of the thighs, parts of the abdomen and buttocks, armpits and around the nipples in women As a symptom, it is less common in elderly The infection in animals is called scarcoptic mange the disease may be transmitted from objects but is most often spread by direct skin-to-skin contact, with a higher risk of infection if contact is prolonged Infections require four to six weeks to become symptomatic Re-infection, however, may manifest symptoms within as little as 24 hours Because the symptoms are allergic, their delay in onset is often mirrored by a significant delay in relief after the parasites have been eradicated Crusted scabies, formerly known as Norwegian scabies, is a more severe form of the infection However, most people who develop scabies not contract this form of the disease Crusted scabies occurs when there is a hyper-infestation of scabies mites This means that there are thousands or millions of mites causing excessive flaking of the skin Because there are so many mites, and because the skin is in the process of flaking off, it is highly contagious The rash crusts and resembles psoriasis It can be very extensive and may, if severe, lead to serious secondary bacterial skin infections Crusted scabies mainly occurs in people who are immunocompromised This includes people with HIV/AIDS: those undergoing chemotherapy and frail people who are ill with other conditions Other people at risk are those who are malnourished, have learning difficulties (meaning that they cannot comprehend or respond to the itch), or have nerve problems (meaning that they cannot feel the itch) In crusted scabies, the mites can survive for up to a week In a hospital scenario, even minimally exposed people, such as cleaners and laundry personnel, are at risk from the parasite In an institution where an outbreak of crusted scabies occurs, treatment with an insecticide is needed However, a healthy person with a normal immune system would develop "normal" scabies if infected with the scabies mite following contact with someone who had crusted scabies Scabies tends to be diagnosed clinically on the basis of typical symptoms Often, a doctor will find one or more mite burrows on the skin to confirm the diagnosis It is, however, sometimes difficult to tell the difference between the rash caused by scabies and some other skin conditions Therefore, if there is any doubt about the diagnosis, a scraping of skin is sometimes sent to the laboratory for examination under microscope Scabies can be effectively treated with a number of medications Permethrin cream is the most effective, but is expensive compared to other treatments Crotamitan is less effective, but also nontoxic and soothing, while Ivermectin may be used orally and topically Treatment with Lindane preparations, however, has fallen out of favour due to high toxicity and parasite resistance Scabies is A More than a thousand years old B A disease of the Celsus C A disease which can last for seven years D Caught from animals 2.What is the closest meaning of the word “parasite”? A A skin disease caused by mites B An organism which lives in or on another one C “many legs” D A place on the skin where disease occurs What is the direct cause of Scabies? A Females mites depositing eggs in the epidermis B 3-4 weeks of exposure to the sun C Male mites moving over the skin D Young mites moulting skin What are the physical effects of having mites under the skin? A The constant need to scratch B Circles of bites appear on the skin C Distractions, especially in hot weather D The skin feels very warm, especially at night The rash associated with scabies is A Found at any location on the body B Found on the back of the body C Known as sarcoptic mange D Only found on women How does the disease spread? A Following treatment with a number of medications B By actions such as hand holding C By 24hours’ exposure to the sun D Mostly by individuals touching objects What happens in the case of crusted scabies? A It may result in psoriasis and other diseases B It is a result of a massive presence of parasite C It is more common than regular scabies D The patient’s immune system suffers Crusted scabies is serious because A It affects healthy people who come into contact with those with the condition B All hospitals have these parasites C It affects people with a poor immune system D It means a person cannot have chemotherapy Why is scabies sometimes difficult to diagnose? A Many burrows are present, which makes diagnosis problematic B The skin rash is not always visible C The patient may have damaged the skin and made it worse D It cannot always be distinguished from other skin problems 10 In the penultimate paragraph, what does the word “scraping” mean? A Small piece B Microscope C Photograph D Blood sample WHEN A STROKE IS SILENT A stroke is a loss of blood flow in the brain There are two kinds of stroke One is an ischemic stroke It happens when a blood vessel in the brain gets blocked The other kind is called a hemorrhagic, or bleeding stroke This happens when a blood vessel breaks Strokes can cause death or disability Bleeding strokes are more likely to kill than ischemic strokes But ischemic strokes are more common and doctors can treat them with a drug that breaks up blood clots If you think someone is having a stroke, you should seek help immediately Experts at the United States National Institutes of Health say the treatment has to begin within three hours But they say people need to get to the hospital within one hour so that doctors have time to examine them Usually the warning signs appear suddenly These include trouble walking, weakness especially on one side of the body, difficulty seeing and difficulty speaking Yet a recent study showed that seemingly healthy middle-aged people can suffer a stroke without immediately knowing it The study involved about two thousand people They were the children of men and women who took part in a major research project in Massachusetts called the Framingham Heart Study The average age in the new study was sixty-two The people were examined every four to eight years They were given M.R.I., magnetic resonance imaging, tests to inspect for damaged brain tissue and signs of stroke The imaging showed that nearly eleven percent of those with no reported stroke had suffered a silent cerebral infarction, or silent stroke Silent strokes are brain injuries likely caused by a blockage that limits blood supply to the brain 1.One of stroke causes is the blockage of a blood vessel in the brain 2. Death or disability can be caused by strokes. 3. Ischemic strokes are more serious than bleeding strokes. Doctors can treat hemorrhagic strokes with a drug that breaks up blood clots Stroke sufferers need to go to the hospital in day for being examined The treatment for those who have a stroke has to begin within three hours. 7.Most cases, the warning signs occur unexpectedly 8. Poor vision is warned as one of the signs of a stroke 9. Healthy middle-aged people can suffer a stroke without immediately knowing it. 10. The people in the study were examined every four years OBSESSIVE-COMPULSIVE DISORDER (OCD) SYMPTOMS OCD symptoms generally begin between the age of 10 and 24 and continue indefinitely until a person seeks treatment A child's upbringing does not seem to be part of the cause of the disorder, though stress can make the symptoms stronger The underlying causes of OCD have been researched greatly and point to a number of different genetic factors While studies show that OCD and its related anxiety disorders are often passed down through families, the specific symptoms for each family member are rarely the same For example, a mother who is obsessed with order may have a son who can't stop thinking about a single word or number Research on OCD sufferers has found certain physiological trends In particular, many studies show an overactivity of blood circulation in certain areas of the brain As a result of this increase in blood flow, the sero-toninergic system, which regulates emotions, is unable to function effectively Studies have also shown that OCD sufferers have less serotonin than the average person This type of abnormality is also observed in Tourette syndrome and Attention Deficit Hyperactive Disorder People who developed tics as children are found to be more susceptible to OCD as well Many reports of OCD point to infections that can trigger the disorder, namely streptococcal infections It is believed that a case of childhood strep throat can elicit a response from the immune system that produces certain neuropsychiatric disorders, such as OCD Because OCD sufferers tend to be so secretive about their symptoms, they often put off treatment for many years The average OCD sufferer waits about 17 years before receiving medical attention As with many anxiety disorders, early diagnosis and proper medication can lessen many of the symptoms and allow people to live fairly normal lives Most treatment plans for OCD involve a combination of medication and psy-chotherapy Both cognitive and behavioral therapies are used to teach patients about their disorder and work through the anxiety Serotonin reuptake inhibitors are prescribed to increase the brain's concentration of serotonin This medication successfully reduces the symptoms in many OCD sufferers in a short amount of time For cases when OCD is linked to streptococcal infection, antibiotic therapy is sometimes all that is needed 1.OCD often results from the way a child is raised 2.Stress can have an effect on OCD 3.OCD sufferers are deficient in serotonin 4.Obsessive-compulsive disorder usually begins after the age of 17 5.Many OCD patients prefer psychotherapy to medication 6.OCD is very difficult to treat 7.Many OCD sufferers keep their problem a secret 8.Antibiotics can be used to treat OCD YOUR OWN MEDICINE Too much self-help can be bad for your health “ONE of the first duties of the physician is to educate the masses not to take medicine,” observed William Osler, one of the giants of 19th-century medicine It is a lesson that I, as a pillpopping member of the public, have learned the hard way Several years ago, I was given a prescription for an acne medication which worked wonders for my complexion—so much so that when the prescription ran out, I kept refilling it myself, thanks to a friendly neighbourhood pharmacist I pride myself on being a fully empowered health-care consumer, being well-informed (keeping up with medical developments is, after all, my job), with a doctorate in immunology, and with enough money and determination to take treatment of minor complaints into my own hands In this case, I was also extremely foolish After a few months on the medication, I started to experience dizzy spells I dismissed them as overwork, and continued to take the pills About a year later, those spells became a curse I awoke one day to find the world spinning around me For a week, I lay in a darkened room with my eyes tightly shut Every time I opened them, I would start to vomit Doctors have a word for this living hell—auditory nerve damage Thankfully, I recovered, but not without losing my balance for several weeks and becoming permanently deaf in one ear There is no proof that my illness was caused by do-it-yourself doctoring But once I stopped taking the pills, the dizziness and other side-effects ceased An experience like that would give anyone a healthy appreciation of the limits to self-help But these days people are being encouraged—indeed, expected—to take personal control of their own bodies This is sound advice when it comes to staying healthy: sticking to a sensible diet, taking regular exercise, consuming alcohol in moderation, and refraining from smoking But I wonder about the wisdom of such an approach when it comes to making people better as opposed to merely keeping them well On the road to recovery, who should be in the driver's seat—doctor or patient? Certainly, there are powerful forces—social, political and legal as well as economic—that are jostling doctors out of taking full charge of their patient's health For one thing, professional paternalism is no longer fashionable in western society Today, your banker, lawyer and, above all, your physician is supposed to be an adviser, not an unquestioned authority who singlemindedly determines the course of action necessary Malpractice litigation, especially in America, has pushed the medical profession into shifting much of the responsibility for taking decisions on to the patients themselves For another thing, easy access to medical information on the internet and elsewhere is giving patients an illusion of expert knowledge with which to challenge—and, increasingly, dictate—their doctors' decisions Pharmaceutical companies have been quick to take advantage of this trend When a blitz of television commercials encourages viewers to “ask your doctor” about the latest wonder drug, chances are your doctor will prescribe it for you As one American expert on medical ethics has noted, in many branches of medicine, the doctor has become simply a waiter, and the patient a customer ordering from a menu of treatments There is a fundamental inequality in the doctor-patient relationship that no amount of education and empowerment can resolve Meanwhile, as governments and employers struggle to pay for expensive new medicines, they are trying to move more of the cost of treatment, and therefore more of the responsibility, on to patients—rolling back support in the process to where it was before the rise of state-sponsored medicine In America, the rise of co-payments and medical-savings accounts are signs of these “new old times” Drugmakers have also caught on to this economic trend, switching many of their products from being available only on prescription—where doctors and penny-pinching insurance firms control access—to becoming available as over-the-counter remedies that consumers choose and pay for themselves The drive to turn patients into self-reliant health-care consumers needs to be watched carefully—for the simple reason that shopping for medical treatment will never be the same as shopping for a flat-screen TV There is a fundamental inequality in the doctor-patient relationship that no amount of education and empowerment can resolve You wouldn't try to buy a new car with a complicated lease agreement when feeling like death Likewise, a sick patient visiting a healthy care-giver, will inevitably be entering into a one-sided relationship This is not to say that public education in health matters should be discouraged Nor does it mean that people should be dissuaded from doing all they can to look after themselves As the history of AIDS has shown, informed patients can be a powerful force for change when it comes to improving medical practices But this needs to be part of a partnership between doctors and patients, not a substitute for it A Choose at least one answer: According to Shereen El Feki, which of the following benefits when patients become more responsible for their healthcare? Choose three answers from A-F a Television companies b Insurance companies c Lawyers d Doctors e Drug company f Governments According to the writer, responsibility for healthcare is being transferred to patients because of a Legal action against patients b The high cost of healthcare c Changes in public attitude d The availability of non-prescription medicines e The availability of information f Advances in healthcare B Yes/No/Not Given Do the following questions agree with the views of the writer? Yes if the statement agrees with the views of the writer No If the statement contradicts the views of the writer Not Given If it is impossible to say what the writer thinks about this The writer suffered from a skin complaint The writer is certain that the medication was responsible for her 5.The writer eats sensibly and takes regular exercise 6.People should be encouraged to take responsibility for maintaining their health 7.Patients expect their doctor to take responsibility for making them well Doctors are making more use of the Internet than in the past Patients have more influence over their doctors’ decisions than in the past 10 A relationship between a doctor and a patient is always unbalanced CASE STUDY Case Study 1: Esophageal Spasm B.R., a 53-year-old woman, consulted with her primary physician because of occasional episodes of dysphagia with moderate to severe tight, gripping pain in her midthorax She reported that the onset was sudden after ingestion of certain foods or beverages, beginning retrosternally and radiating to the cervical and dorsal regions The pain was not relieved by assuming a supine position or holding her breath B.R also stated that she felt like her heart was racing and that she might be having a heart attack She denied any dyspepsia, vomiting, or dyspnea Her doctor suspected acute esophageal spasm or possibly a paraesophageal), hiatal hernia and referred B.R to a gastroenterologist for a gastroscopy and esophageal manometry study (pressure measurement) She also underwent a barium swallow study under fluoroscopic imaging Case Study 2: HIV Infection and Tuberculosis T.H., a 48-year-old man, was an admitted intravenous (IV) drug user and occasionally abused alcohol Over weeks, he had experienced fever, night sweats, malaise, a cough, and a 10-1b weight loss He was also concerned about several discolored lesions that had erupted weeks before on his aims and legs T.H made an appointment with a physician assistant (PA) at the neighborhood clinic On examination, the PA noted bilateral anterior cervical and axillary lymphadenopathy and pyrexia T.H.'s temperature was 39°C The PA sent T.H to the hospital for further studies T.H.'s chest radiograph (x-ray image) showed paratracheal adenopathy and bilateral interstitial infiltrates, suspicious of tuberculosis (TB) His blood study results were positive for human immunodeficiency virus (HIV) and showed a low lymphocyte count Sputum and bronchoscopic lavage (washing) fluid were positive for an acid-fast bacillus (AFB), and a PPD (purified protein derivative) skin test result was also positive Based on these findings, T.H was diagnosed with HIV, TB, and Kaposi sarcoma related to past IV drug abuse Case Study 3: Endocarditis D.A., a 37-year-old alcoholic man, sought treatment after experiencing several days of high fever and generalized weakness on return from his vacation D.A.'s family doctor suspected cardiac involvement because of D.A.'s history of rheumatic fever The doctor was concerned because D.A.'s brother had died of acute malignant hyperpyrexia during surgery at the age of 12 D.A was referred to a cardiologist, who scheduled an electrocardiogram (ECG) and a transesophageal echocardiogram (M),,, D.A was admitted to the hospital with subacute bacterial endocarditis (SBE) and placed on highdose, IV antibiotics and bed rest He had also developed a heart murmur, 'which was diagnosed as idiopathic hypertrophic, subaortic stenosis (IHSS) The cervical region is the region of the: A heart B uterus C leg D head E neck A word that has the same meaning as dorsal is: A anterior B caudal C inferior D superior E posterior In referring to tissues, the term interstitial means: A under cells B around cells C through cells D within cells E between cells The term axillary refers to the: A abdomen B wrist C armpit D bladder E groin The term pyrexia refers to a : A spasm B fever C stone D tumor E poison Dyspepsia refers to indigestion Dysphagia and dyspnea refer to difficulty with _ and _ swallowing and urinating A B C D sleeping and breathingCase swallowing and breathing breathing and coughing walking and chewing gum Paraesophageal and paratracheal refer to the esophagus and trachea A under B superior to C in between D near or beside E within The endocardium is the lining of the inside of the heart Endocarditis refers to a of the lining of the heart A narrowing B thinning C overgrowth of tissue D inflammation E cancerous growth D.A.’s heart murmur was caused by a stenosis, or _ of the aortic valve of his heart A thinning B cancerous growth C overgrowth of tissue D narrowing E inflammation 10 The term for a condition or disease of unknown etiology is: A chronic B acute C hypertrophic D idiopathic E stenosis LYME DISEASE When Allan Little began to feel ill, he knew almost immediately what it was - Lyme Disease But getting a medical diagnosis, and treatment, took a lot longer I'd been going for years to the same little town in New England and Lyme Disease is everywhere there You can't walk more than a few hundred metres in the countryside without coming across a public health notice warning you not to get bitten by a deer tick So the intense headache, the aching limbs, the burning joints, the ferocious fever and night sweats that hit me in a matter of hours, a few days after I'd got back to London, were all consistent with what I'd read about the condition I went to a London GP, who wasn't convinced She took a blood sample and advised me to go home, rest, and take paracetamol The next day, the blood test came back It was negative for Lyme My condition grew worse I could hardly stand up I called another doctor, who came to my house He was also sceptical He took another blood test This too came back negative But he gave me a prescription for powerful painkillers which made me feel well enough to get on a train to Edinburgh, my home town Within three hours of arriving at Waverley Station I was an in-patient in the Infectious Diseases Department of the city's Western General Hospital: diagnosis, Acute Lyme Disease By now I had found the tick bite and the distinctive livid red rash, about six inches in diameter (To be fair to those London GPs, I hadn't noticed it when I'd consulted them.) "It's attacked your liver," the Edinburgh Consultant said "You have three distinct kinds of liver inflammation" I made a lame sick-bed joke: "You're sure that's not like Lager-and-Lime Disease then?" She laughed politely and reassured me that that would look quite different Why then had both blood tests come back negative? Dr Roger Evans of Raigmore Hospital in Inverness is one of the UK's leading Lyme Disease researchers "In early Lyme Disease," he told me, "the test is not reliable because no antibodies have been produced In the first few weeks of infection, you could test negative, but still have Lyme Disease." This is a problem for GPs, especially in urban centres where Lyme Disease is unfamiliar Lyme is not a viral infection It's bacterial GPs will not prescribe antibiotics if they think you're showing symptoms of a viral infection - and it does look and feel like a bad case of flu, or chronic fatigue syndrome, neither of which can, or should, be treated with antibiotics "In the early weeks of infection, when the blood test is not reliable," says Evans, "the GP needs to assess the patient clinically, looking for other symptoms that identify Lyme Disease." In other words, symptoms that distinguish it from flu If you have been bitten: Remove the tick as soon as possible - the safest way is to use a pair of fine-tipped tweezers, or a tick removal tool Grasp the tick as close to the skin as possible, pull upwards slowly and firmly, as mouthparts left in the skin can cause a local infection Once removed, apply antiseptic to the bite area, or wash with soap and water and keep an eye on it for several weeks for any changes Contact your GP if you begin to feel unwell and remember to tell them you were bitten by a tick or have recently spent time outdoors Catching it early is vital Angela Howard fell ill with Lyme Disease in the 1990s She had never heard of it Her doctor, she says, told her to go home and see whether her symptoms persisted It was only when a visiting American friend saw the distinctive rash - concentric red rings around the place where the tick bite had occurred that she realised she might have Lyme Disease She says her doctor was still reluctant to diagnose Lyme "Doctors say you can only get this abroad - that it comes from overseas But I hadn't been abroad I'd been picnicking in Wiltshire." She was not treated early and her symptoms have persisted for years There is an accumulation of anecdotal evidence that Lyme Disease often goes undiagnosed One problem is that no-one knows how prevalent it now is It is not a notifiable disease in the National Health Service - doctors are not required to inform a central database when they diagnose it So there is no reliable evidence of how widespread it is, or where in the country you are most likely to get it Roger Evans at Raigmore Hospital wants to remedy that "We're using Scotland as a pilot study," he said "We're trying to create maps of areas where there's a risk of tick exposure We're using satellite data from the European Space Agency to create an app that will give information, but which will also be interactive, so that users can put in information about where they've been bitten and whether the Lyme Disease rash has appeared." Why has Lyme, which 30 years ago seemed largely limited to a small area of New England Lyme is the town in Connecticut where it was first identified - now so prevalent across the continental USA and in Europe? One theory is climate change: that small gradations in climate can create new habitats for micro-organisms, or keep them alive and active for longer I was struck, at the time of my own treatment, that awareness was far greater in Scotland than in England and Wales And awareness of the condition is vital to catching it early For when you catch it early, treatment is easy and in most cases successful It floors you though It took me four or five months to get my strength and stamina back It is a debilitating and dangerous illness and there is no doubt that it is getting more common You can get it in the Scottish Highlands, in Devon and Cornwall, in Richmond Park in London and probably in your own back garden anywhere where there are small furry animals on whose skins a deer tick can live If you get it, you can get treatment But take it from me: it really helps if you know what it is you've got Alan had no doubt about his illness from the beginning 2.Both blood tests were negative for Lyme Disease 3 Alan didn’t become a Waverley Station patient for more than hours 4.Blood tests were inaccurate because they were taken unprofessionally Lyme Disease is very unfamiliar in the UK Complete the sentences below Write NO MORE THAN TWO WORDS from the passage for each answer 6.Angela’s friend recognized the Lyme Disease as soon as she saw the rash 7.One problem is, it’s unknown how _ Lyme Disease is nowadays Roger Evans says that they try to create maps of Scotland where there’s a risk of The one possible reason for Lyme Disease to move all over the world is 10 You can catch the disease even in your own back